<%@ include file="/view/template/header1.jsp"%>	
	<div id="content">
    	<%@ include file="/view/supply_chain/pharmacy_all.jsp"%>
        <div class="right-content">
			<div class="box">
				<h1><s:text name="menu.supply_chain.request_drugs"></s:text></h1>
				<s:form action="request_drugs_form">
					<div class="con-part"><span><s:text name="requestDrugs1.requestId" />
					</span> <s:textfield name="requestDrugs.requestId" class="input-text"></s:textfield>
					</div>

					<div class="con-part"><span><s:text name="requestDrugs1.drugId" />
					</span> <s:textfield name="requestDrugs.drugId" class="input-text"></s:textfield>
					</div>

					<div class="con-part"><span><s:text name="requestDrugs1.unitOrWard" />
					</span> <s:select key="requestDrugs.unitOrWard" cssClass="select_box" list="#{'1': '1', '2': '2', '3': '3', '4': '4', '5': '5', '6': '6', '7': '7', '8': '8', '9': '9', '10': '10'}" headerKey="1" headerValue="---Select Ward---"/>
					</div>

					<div class="con-part"><span><s:text name="requestDrugs1.minAmount" />
					</span> <s:textfield name="requestDrugs.minAmount" class="input-text"></s:textfield>
					</div>

					<div class="con-part"><span><s:text name="requestDrugs1.maxAmount" />
					</span> <s:textfield name="requestDrugs.maxAmount" class="input-text"></s:textfield>
					</div>

					<div class="con-part"><span><s:text name="requestDrugs1.amountUnits" />
					</span> <s:select key="requestDrugs.amountUnits" cssClass="select_box" list="#{'mg': 'Mili-grams', 'ml': 'Mili-litre'}" headerKey="mg" headerValue="---Select unit---"/>
					</div>

					<div class="con-part"><span><s:text name="requestDrugs1.quantity" />
					</span> <s:textfield name="requestDrugs.quantity" class="input-text"></s:textfield>
					</div>

					<div class="con-part"><span><s:text name="requestDrugs1.urgency" />
					</span> <s:select key="requestDrugs.urgency" cssClass="select_box" list="#{'High':'high','Moderate':'moderate','Low':'low'}" headerKey="Low" headerValue="---Select Urgency---" />
					</div>

					<div class="con-part"><span><s:text name="requestDrugs1.requestDate" />
					</span> <sj:datepicker key="requestDrugs.requestDate" required="true" timepicker="true"/>
					</div>

					<div class="con-part"><span><s:text name="requestDrugs1.enteredByID" />
					</span> <s:textfield name="requestDrugs.enteredByID" class="input-text"></s:textfield>
					</div>
					
					<div class="con-part"><span><s:text name="requestDrugs1.verifiedByID"/> </span> <s:textfield
							name="requestDrugs.verifiedByID" class="input-text"></s:textfield>
					</div>
					
					<div class="con-part"><span>&nbsp;</span> <!-- requestDrugs.requestDrugsForm -->
						<s:submit key="requestDrugs.request" cssClass="green" align="center" />
					</div>
					
					<div class="con-part"><s:if test="%{message.message!=empty}">
							<s:property value="message.message" />
						</s:if> </div>
				</s:form>
				
			</div>
		</div>
	</div>
<%@ include file="/view/template/footer.jsp"%>
